Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals

Abstract

Objective To compare macular choroidal thickness between cigarette smokers, those with a history of smoking, and nonsmokers in patients over 65 years of age with earlyatrophic age-related macular degeneration (AMD) and normals. Methods Prospective, consecutive, observational case series. Enhanced depth imaging spectral domain optical coherence tomography 12-line radial scans were performed and choroidal thickness manually quantified at 84 points in the central 3 mm of the macula. Data of normals, soft drusen alone, and soft drusen with additional features of early AMD were compared. A multivariate analysis of variance (MANOVA) model, controlling for age, was constructed to evaluate the effect of smoking history and AMD features on choroidal thickness. Results A history of smoking was significantly associated with a thinner choroid across all patients via logistic regression (P ¼ 0.004; O.R. ¼ 12.4). Mean macular choroidal thickness was thinner for smokers (148±63 mm) than for nonsmokers (181±65 mm) among all diagnosis categories (P ¼ 0.003). Subgroup analysis of patients with AMD features revealed a similar decreased choroidal thickness in smokers (121 ± 41 mm) compared with nonsmokers (146 ± 46 mm, P ¼ 0.006). Bivariate analysis revealed an association between increased pack-years of smoking and a thin choroid across all patients (Po0.001) and among patients with features of early AMD (Po0.001). Both the presence of features of macular degeneration (Po0.001) and a history of smoking (P ¼ 0.024) were associated with decreased choroidal thickness in a MANOVA model. ConclusionChronic cigarette smoke exposure may be associated with decreased choroidal thickness. There may be an anatomic sequelae to chronic tobacco smoke exposure that underlies previously reported AMD risk.

Age-Related Macular Degeneration: A Complementopathy?

“…Enhanced C3a release resulted in the generation of IL-1 [42], which is a powerful cytokine that can generate further production of inflammatory cytokines by RPE cells [66]. Smoking leads to a decrease in choroidal thickness, but whether this is due to increased local complement activation has still to be investigated [67]. …”

Evaluation of the Effects of Chronic Smoking on Choroidal Thickness Measured by Spectral Optical Coherence Tomography

“…20 Sigler ve ark., 65 yaş üstü kişilerde yaşa bağlı makula dejenerasyonu varlığından bağımsız olarak sigara kullanımının incelmiş KK ile ilişkili olduğunu bildirmişlerdir. 21 Çalışmamızdaki hastalar Sigler ve ark.nın çalışmasındaki hastalara göre daha genç idi, bu da sigaranın koroid üzerindeki etkilerinin daha genç yaşlarda da ortaya çıkabileceğini göstermektedir.…”

Sigara İçmeyi Bırakan Hastalarda Koroid Kalınlığı Değişiklikleri

“…Sinir sistemi, Kalp-Damar Sistemi ve özellikle de Solunum Sisteminde birçok patolojiye ve bunun sonucunda da bu sistemlerde ciddi hastalıklara veya kansere sebep olmaktadır (1,2). Bunun yanında sigara içmenin katarakt, primer açık açılı glokom, keratit, yaşa bağlı makula dejenerasyonu, retinal damar tıkanıklıkları, Grave's oftalmopati ve anterior iskemik optik nöropati gibi bazı ciddi göz problemlerine de yol açtığı gösterilmiştir (3)(4)(5).…”

“…Koroid damar yetmezliği ve koroid kalınlığındaki incelme, görmeyi bozabilecek fotoreseptör hasarına, sinir lifi tabakasında incelme ve retina pigment epiteli bozukluklarına yol açabilir (6)(7)(8). Aynı zamanda sigaranın yaşa bağlı makula dejenerasansı, polipoidal koroid vaskulopati veya oküler histoplazmozis gibi patolojilere yol açan koroid neovaskülarizasyonu riskini de artırdığı gösterilmiştir (4,(9)(10)(11)(12)(13)(14). Ayrıca uzun süre sigara içenlerde koroid kan akımı, içmeyenlere oranla daha yavaştır (15).…”